Case Manager

Humana • Reedsburg, WI

1d • Hybrid

About The Position

Become a part of our caring community Join the Humana team in this exciting role as a Case Manager. Reporting to the Manager of Care Management Support, you will provide care coordination, support, and education to members enrolled Medicaid, BadgerCare, SSI. You will work from home but will also be required to and visit your members in their home or community setting (approximately 50% travel).

Requirements

• Bachelor's degree in health and human services field
• License in health and human services field (CSW, LPC, LPC-IT, OT-A, etc)
• 2 or more years in case management of related experience
• Must have a private room with a locked door that can be used as a home office to ensure privacy while you work

Nice To Haves

• Bilingual
• Experience working in a managed care organization
• Prior experience with Medicare & Medicaid recipients

Responsibilities

• Conduct comprehensive Medicaid-required psychosocial and functional assessments as part of the care management process to identify member needs, risks, strengths, and barriers affecting health and independence.
• Develop, implement, coordinate, and monitor individualized, person‑centered care plans following Medicaid program requirements, ensuring services and supports align with member‑identified goals and outcomes.
• Perform ongoing reassessments and care plan updates at required intervals and as member needs change, monitoring health status, safety, service effectiveness, and progress toward desired outcomes.
• Conduct required face‑to‑face visits with members in their homes or community settings to assess needs, evaluate service delivery, provide education, and support member engagement in care.
• Coordinate and monitor Medicaid-covered services, and community-based resources to ensure access, continuity of care, and avoidance of service gaps.
• Document assessments, face‑to‑face visits, care plans, member interactions, and service coordination activities following Medicaid, contractual, and organizational documentation standards.
• Educate members on preventive health measures, wellness strategies, and care adherence to support improved health outcomes and compliance with Pay for Performance (P4P) quality measures.
• Build collaborative relationships with members, families, caregivers, providers, and community agencies to promote engagement, trust, and care coordination.
• Collaborate with physicians, interdisciplinary care teams, and other healthcare professionals to coordinate and integrate medical, behavioral, and social services.
• Educate members and providers regarding Medicaid benefits, covered services, provider roles, and appropriate use of healthcare services; refer members to community resources and social services.

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level